The "At-Risk Chin" Gets A New Treatment

A dermatologist reviews the latest.

By
Yoon-Soo Cindy Bae, MD

Oct 19, 2015

In the past six months the FDA has approved and cleared two new ways in which submental fat, i.e., an "at-risk chin" can be eradicated. First there was Kybella, a compound that dissolves fat, and now there's Coolmini, a new applicator for Coolsculpting, a device that freezes fat. Until recently, liposuction was the only way to effectively treat a double chin. But which treatment gives the best results? I interviewed the dermatologists behind the development of Kybella and Coolmini for a chin to chin comparison.

"Kybella is a breakthrough injectable aesthetic medication that will create significant interest in neck rejuvenation. At this point in time, there's no device or laser that can demonstrate the same safety and efficacy. It took ten years of rigorous study for FDA approval," says Adam Rotunda, MD, professor of Dermatology at the University of California, Los Angeles and Irvine (he was a resident doctor when he discovered the use of Kybella over a decade ago). "Unlike devices, whose hand piece is generally one-size-fits-all, the clinician can customize the injectable Kybella treatment and contour the fat reduction to the patients' unique anatomy in less than five minutes."

Coolsculpting technology, or cryolipolysis, "works by selectively cooling unwanted collections of fat cells, causing them to die. The Coolmini is a new applicator made specifically for treating the neck," says Rox Anderson, MD, Professor of Dermatology at Harvard Medical School and Director of the Wellman Center for Photomedicine in Boston, who helped to develop Coolsculpting technology. "Cryolipolysis has the advantages that no chemicals are injected, treatment is nearly painless, and it does not depend on a skillful needle injection. There is also more [post market] experience with cryolipolysis, which works very well for treating belly, flank, and thigh fat in over a million patients."

Anderson reports: "Both of these treatments [Kybella and Coolsculpting] work well [and] target fat, but they do more than just remove fat; laxity, wrinkles, and sagging of the skin are usually improved." Dr. Rotunda agrees, "Studies using standardized evaluation scales have also demonstrated skin tightening in patients treated with Kybella, but the company cannot make claims to skin tightening as an outcome of treatment."

Both experts look forward to future clinical studies comparing the two therapies in order to make further claims about rejuvenation. "In the end, patients will be the judge of which minimally invasive treatment, injection, or device, best suits their needs," Rotunda says.

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